It’s a snow day here at ASHA and for many of our members on the East Coast. So whether (pun intended!) you’re snowed in or not, curl up with some of our most popular posts from 2014 in this compilation published earlier this year.

From stuttering to aphasia, hearing loss to hearing aids, early intervention to telepractice and more, ASHA’s blog posts are written by you—our members—sharing knowledge with peers on a variety of subjects. But there’s no doubt about it, pediatric feeding has been the topic on ASHAsphere in 2014!

SLP Melanie Potock specializes in pediatric feeding and explains that sippy cups were created to keep floors clean, not as a tool to be used for developing oral motor skills.

“Sippy cups were invented for parents, not for kids. The next transition from breast and/or bottle is to learn to drink from an open cup held by an adult in order to limit spills or to learn to drink from a straw cup. Once a child transitions to a cup with a straw, I suggest cutting down the straw so that the child can just get his lips around it, but can’t anchor his tongue underneath it.” – Potock

For parents interested in following the Baby Led Weaning (BLW) philosophy of pediatric feeding, which states that babies are developmentally capable of reaching for food and putting it in their mouths at about 6 months of age, SLP Melanie Potock shares some thoughts to consider.

“For children in feeding therapy, incorporating some aspects of BLW is dependent on that child’s individual delays or challenges and where they are in the developmental process, regardless of chronological age. My primary concern for any child is safety—be aware and be informed, while respecting each family’s mealtime culture.” – Potock

For kids who only eat a limited number of foods, it can be difficult for parents to provide the right nutrition for their kids. SLP Melanie Potock shares her top 10 suggestions for preventing food jag.

“Food Left on the Plate is NOT Wasted: Even if it ends up in the compost, the purpose of the food’s presence on a child’s plate is for him to see it, smell it, touch it, hear it crunch under his fork and perhaps, taste it. So if the best he can do is pick it up and chat with you about the properties of green beans, then hurray! That’s never a waste, because he’s learning about a new food.” – Potock

What’s the biggest open secret in our field? Each of us might have slightly different answers. Here’s mine: the reason so many students are blocked from receiving needed services is because their home states have not updated their Medicaid telepractice policies.

Children who qualify for Medicaid coverage, by definition, are from low-income families. My experience is that these children are disproportionately affected by the shortage of SLPs and could therefore benefit a great deal from access to treatments delivered via telepractice.

In addition, many schools, when faced with tight budgets, simply do not have the money to hire additional SLPs–telepractice or not–without Medicaid funds.

This places an unfair burden on the rural and urban schools that need telepractice the most. They struggle more than their affluent peers to find qualified SLPs. One reason is that those wealthier districts can pay substantially more for treatment delivered via telepractice if state Medicaid policies haven’t been updated to reimburse for online services.

This isn’t the most surprising part of the secret, however. That honor goes to how easily states can make the change. Consider this:

The federal government, which partners with each state on its Medicaid plan, has already approved billing for telepractice. That’s right, the Centers for Medicare & Medicaid Services already has an approved billing treatment for treatment delivered via telepractice.

All reimbursements for telepractice are paid for entirely by the federal government. This means that states don’t pay for additional reimbursements out of pocket. Let me repeat that one more time: allowing reimbursement for telepractice increases access to services without requiring additional funds from your state’s Medicaid program.

For all states that PresenceLearning has researched—aside from Indiana—allowing reimbursement for telepractice is as simple as publishing a clarifying policy memo. The memo should say that online services can be billed with the same codes as traditional sessions as long as a “GT” telepractice modifier is included for tracking purposes.

It is important to keep in mind that telepractice is just a different delivery method for services already approved by CMS and reimbursed by Medicaid in schools.SLPs provide online services using the same approaches and materials they would use if they were physically at the school site.

What can you do to help students get the treatment they need by motivating your state to write that memo?

Speak to stakeholders to build a consensus. Stakeholders include: ASHA, state licensing boards, special education directors, state departments of special education and directors of child health programs for your schools.

Consult state-level billing agents on the best way to document services to ensure program integrity.

Network with colleagues using telepractice to find out which states currently approve Medicaid funding for telepractice.

There are eight states that reimburse for telepractice services. They include: Colorado, Maine, Minnesota, North Dakota, New Mexico, Ohio, Oregon and Virginia. In addition, reimbursement for telepractice services are pending in California and Michigan.[Note from ASHA editors: This list was published in July 2013, so it may have changed. Our December issue focused on telepractice and has a slightly different list of states offering reimbursement.]

Contact state speech and hearing associations or state-level Medicaid directors to find out how you can assist in getting Medicaid reimbursement for telepractice services. Let’s work together to ensure students who need our services receive them and schools receive the appropriate funding from Medicaid.

Melissa Jakubowitz M.A. CCC-SLP, vice president of clinical services at PresenceLearning,is an SLP with more than 20 years of clinical and managerial experience, Melissa is a Board Recognized Specialist in Child Language. She is a past-president of the California Speech-Language-Hearing Association and is also active in ASHA, serving as a Legislative Counselor for 12 years. Melissa began her career working in the public schools and can be reached at melissa@presencelearning.com.

I have sometimes felt overwhelmed with the number of children on my caseload who struggle with reading. It shouldn’t surprise me, as spoken language and hearing speech sounds is the foundation for reading text. We know that children with speech and language delays are at risk for reading failure. It’s important for the speech-language pathologist to understand how delays in early sound productions interfere with the process of reading and learn simple interventions to remediate both articulation and early literacy skills at the same time.

It is common to see many children in preschool, kindergarten and first grade struggling with articulation of sounds. Underneath that struggle is a child whose sound/symbol system is weak. That means this system may also be weak in hearing sounds, learning to read sounds and in learning to write sounds. This is the perfect time to get involved with the classroom teacher and use your skills to help all children make sense of sounds and print. I have found it essential to teach an overlap of skills to the students on my caseload who present with moderate to severe articulation errors.

Reading and speech tips

Here are some general pointers on working on both speech and reading:

Review with the kindergarten staff how to teach all students how sounds are made, feel, look and touch as they are introducing alphabet sounds.

Talk about where the sounds are made in their mouths. Do they make the sound in the front of their mouth? Do they use airflow? Did their voice turn on or was it off? Was the sound made with their lips or their tongue? This practice helps students connect hearing the sounds to what their mouths are doing when saying them.

Teach children the correct way to produce sounds, making sure they don’t begin to add a “schwa” sound like ‘uh” onto the end of their productions. For example, the “f” says /f/ not /fuh/, the “h” says a silent /huh/ not a voiced /huh/, the “t” says /t/ not a voiced /tuh/, the “p” says /p/ not a voiced /puh/ and the “k” says /k/ not a voiced /kuh/. When children learn to produce sounds with the added schwa they may have trouble when they are sounding out words.

Be an active participant with the classroom teacher when they begin to assess the letters and sounds a child knows. Offer to help give the assessments and take a close look at the results. It’s amazing what you can learn about a child’s speech sound productions and early reading skills just by a simple sound assessment.

Consider an initial sound DVD that is very visual, repetitive and kinesthetically rich. Children can solidify alphabet sounds very quickly when given access to repetitive song-type DVD’s.

Phonemic awareness skills taught in the early grades are extremely important for children with speech articulation difficulties. Children need to be able to hear and play with sounds in words. Work with the child on the skills of blending and segmenting simple CVC words using sounds they are working on.

Teach classroom teachers and children about voiceless and voiced sound pairs. Make a chart and post it in the classrooms. When children understand how these sounds are related, spelling skills improve.

Voice Off

Voice On

f

v

p

b

s

z

t

d

k

g

When a child is reading text

Here are specific things you to can do to help when children read:

Use visual reminder cards with children to remind them to use certain reading strategies. A simple strategy card may include strategies such as “Get your mouth ready” or “Say what you see.”

“Say what you see” is helpful to say to children when they make an error when reading an initial sound in a word. So when a child is trying to read the word “dog” and he says “fat”, explain that if he sees a “d” in the beginning of the word his mouth has to make that sound.

Make simple books with beginning sight words tied to words with the sounds the child is working on. Books like “I see____” or “I like____”. Use blank page books or take a simple book that you own and replace the text with your own, targeting the sounds a child is working on.

Every time a child reads out loud they are practicing oral speech sounds.

Use highlighter tape to visually highlight the sounds a student is working on. Use the tape in books they are reading or in their writing to draw attention to sounds. Students love to use the tape to cover their sounds while another student in a group is reading.

Sue Lease is a speech-language pathologist at Glacier Edge Elementary School in Verona, Wisconsin. She has a particular interest in emergent literacy in young children.

Lately, I feel there is a division between classroom teachers and speech-language pathologists in the schools: an “us” and “them” mentality. Working parallel to one another hoping to reach the same goal is not what is best for our students. While it is true that the professions are separate, they do share a goal—student progress. I believe collaboration is the key to achieving that mutual goal.

Here are a few of the most common situations in which SLPs and teachers have opportunities to collaborate for the benefit of students, and some tips for those situations.

Offer a few minutes to sit down with teachers and walk them through the student’s IEP. Explain the terminology, how speech-language treatment goals will be addressed in the therapy room, and how the classroom teacher can help to target those same goals when the student is in his or her room.

Encourage teachers to speak candidly with speech students. The students are in the classroom more than the therapy room. They will progress further when they are supported and encouraged to use speech-language skills and techniques in all environments.

The teacher can:

Ask for an opportunity to view a therapy session in person or via a recording. Note hand signals and specific wording the therapist employs. Carefully listen for the correct speech sound productions. Witnessing some of the successful techniques will help when targeting these same needs in the classroom.

Support the SLP’s work in the classroom. Students will be motivated to use good speech and language skills when they are aware of shared expectations between the teacher and the SLP.

When the team is gathered for an IEP meeting.

The SLP can:

Provide teachers with a short list of items to think about prior to the meeting.

Encourage teachers to list areas of observed improvement or areas of need, and reference this list during the meeting.

The teacher can:

Speak out about concerns. Some classroom teachers seem to feel they do not know enough about speech-language treatment to comment on progress during IEP meetings. Teacher input contains vital information. Students do not always present speech-language issues in small-group settings.

Share in the ownership of the student’s speech/language success. The teacher is an integral part of the IEP team.

When students miss curriculum content because of pull-out services.

The SLP can:

Involve teachers as much as possible when creating a speech schedule. A little flexibility here can go a very long way. Be willing to adjust the schedule as needed. For example, push into the classroom for speech one week instead of pulling out, if appropriate.

Provide a full (HIPPA-compliant) schedule to teachers highlighting openings for make-up sessions. Keep this schedule updated as the year progresses. You can access a copy of what I use here.

The teacher can:

Ask the SLP if having access to lesson plans might be beneficial. Make the lesson plans available to the SLP in advance of the speech sessions.

Send classroom materials to be used in treatment sessions. Have a new unit in science? Send vocabulary words with your student to speech. Need help with an oral presentation for English? Send the rough draft to speech. Having trouble with basic concepts or following directions in math class? Let the SLP know. All of these things can be worked into a speech session.

Teachers and SLPs serve the needs of students in different ways, but we are all working on expanding children’s knowledge and skills. When we are cognizant of our colleagues’ needs and comfortable in our roles on the team, collaboration will be the start of something amazing: tremendous student progress.

Ashley G. Bonkofsky, MS, CCC-SLP, is a private-practice and school-based SLP in Utah, where her husband is stationed with the U.S. Air Force. She enjoys creating materials for teachers and SLPs and is the author of the blog Sweet Speech (sweetspeech.org). She is an affiliate of ASHA Special Interest Groups 1, Language Learning and Education; and 16, School-Based Issues.

If you want to know what the real talk is at an ASHA Schools Conference, you need to pull up a chair at the lunch tables. That’s where you’ll hear chatter about the most top-of-mind topics for the speech-language pathologists and audiologists who attend.

So it was that this roving blogger sat down to share a sandwich and some conversation with this year’s attendees. Here’s what a sampling of them report are the most burning issues that brought them to Schools 2014 in Steel City: Pittsburgh.

Brianne Young, SLP, Renfrew, Pennsylvania
I want to know how we’ll use the Common Core State Standards. We’re switching to the Common Core totally but we haven’t yet transitioned the speech-language piece of it 100 percent. We started adapting the reading and language standards last year, and nobody’s sure how this will all work. I also want to know more about incorporating Common Core with RTI.

Amy Shaver, SLP, Hamden, Connecticut
As a former stay-at-home mom just getting back into it—I just got hired fulltime by a school for next year—I want to learn more about iPad apps for speech. The technology has changed so dramatically and rapidly in eight years. It’s kind of an odd place to be because as a mom, technology can seem like a big negative. I’m always limiting my kids’ screen time. So it’s an interesting shift to think of it as an educational tool.

Sabrina Hosmer, SLP, Manchester Public Schools, Connecticut
As a bilingual evaluator, I’m here to find out how other SLPs have made systemic changes to their school districts. In our district we have problems of overidentification of speech-language disorders among bilingual children. The children are tested in English, and they’re not supposed to be, but we don’t have enough bilingual SLPs to do appropriate assessments or to serve the bilingual kids who really do have speech-language disorders.

India Parson, SLP, Prince Georges County, Maryland
What’s on my mind? The Common Core—how do we use the literacy standards with children with severe disabilities? And what’s going to happen with tying them to performance evaluations of SLPs, which they’re doing with teachers and are talking about doing with us? The other issue is the shortage of bilingual therapists. We have a big problem of overidentification of disabilities in the bilingual population. We need folks making better diagnostic decisions up front.

Christine Bainbridge, SLP, Ithaca, New York
What’s burning for me is wanting to learn more about central auditory processing disorder—what is the research evidence base on CAPD, how does it truly change children’s functioning in the classroom, and how do we intervene with it in an evidence-based way?

Audrey Webb, SLP, Charlotte, North Carolina
I’m just coming into the K-12 schools this year after working as a preschool SLP for many years, so what’s going on with the Common Core will be big. Of course, a lot of that’s up in the air now because our state legislature just repealed it, but we’ll still be using it for the time being. I’m also big on RTI. I’m a fan of it, and always interested in ways to get teachers on board with it.

Mary Pat McCarthy, SLP, Clarion, Pennsylvania
My reason for going to Schools every year is always to see what the current buzz is. It’s no one thing I want to know. It’s everything, really. I know if I go, I’ll get what I need for the coming school year. This year I’m especially interested in hearing about working with teachers on improving our work on phonology and articulation with kids. But this conference is always a great professional recharge during the summer.

How can we make goal-writing and individualized education programs less daunting? Recently I wrote an article for the upcoming March volume of SIG 16 Perspectives. I took the literature and combined it with what, in my experience working in public schools, makes the process collaborative. Since I’m a visual person, I drew a model:

So as you sit down as a team to write your next IEP, you may want to consider these four parts:

Context:

I apologize to those of you who have heard this from me before, but I can’t stress enough how important it is to remember that language is everywhere. Aside from basic artic goals, we really can embed our goals under most curriculum areas. Look to see how your speech and language targets may actually fit across other areas such as math (descriptive/comparative language), history (explain/describe/narrate), and science (using temporal language to order steps in a process, vocabulary). If our ultimate goal is generalization, then it is logical to think broadly, holistically.

Assessment

Assessment doesn’t happen just at IEP time, it should be ongoing. If an IEP is collaborative, then data can be collected from a variety of general education activities and speech and language activities. Don’t reinvent the wheel; look at the assessments the general education teacher is giving your students and either analyze their findings or offer to provide the assessment. This is not extra work; it helps to inform your intervention. Recently I helped a Kindergarten teacher with a dictation assessment, and was it ever so enlightening!

Review & Reflect

Review your approach honestly; reflection is how we, as practitioners, learn and grow (Tagg, 2007). Since we have very little time in our crazy professional lives, this often falls by the wayside. As related service providers, we need to find time to discuss what we are seeing, and consult with teachers on how this can translate academically. In some cases, this may mean including in the IEP that the team will meet every certain number of weeks, to discuss and update one another on the student’s current performance.

Extend

Think about how to create goals that can extend beyond the immediate environment. For the majority of the students who I see, I am constantly looking for ways to connect academics with independence. A student learning math and money, for example, may need a trip to the store. A student working on following directions may bring a list to the store and come back to follow a recipe. These kinds of experiences make the abstract become concrete.

C.A.R.E is about creating a smooth, efficient and collaborative IEP process. This way we can move on from the paperwork part, and get back to the business of intervention and academic success. For more detailed information, please keep an eye out for my article entitled, “Autism in the schools: IEP best practices at work,” coming out in the next SIG 16 Perspectives issue.

Kerry Davis, EdD, CCC-SLP,is a city-wide speech-language pathologist in the Boston area. Her areas of interest include working with children with multiple disabilities, inclusion in education and professional development. The views on this blog are her own and do not represent those of her employer. Dr. Davis can be followed on Twitter at @DrKDavisslp.

At the beginning of each school year, I have great expectations that this year is the year that all my little speechies are going to manage their behavior well in my treatment room with minimal incentives on my end. So much for great expectations. Because, of course, every year, I’m presented with new challenging behaviors to tackle because we educators know that “all kids are unique and different.”

Just when I think I have mastered all that I need to know about behavior management, one my little sweet speechies decides to bring a new unpleasant behavior into my speech room.

The good news is, I have learned much about managing these behaviors, both in the school setting and at home—from raising two little ones! These are my tips for keeping your therapy room calm and productive:

Say what you mean and mean what you say. Set the behavior expectations for your speech room at the beginning of the year and explain the consequences for not following your expectations. Each session, review these with students who need frequent reminders about their behavior. Visually post your rules and consequences, so they can see and hear them. Don’t be afraid to snap the whip and follow through with your consequences because it sends the message to the whole group that you mean business.

Bring on the visuals. Use visuals to remind students who struggle with transitions about the start and end of activities. I use a Time Timer and two to three warnings to let my students know when the activity will end. I am also creating a visual necklace that displays prompts to help show students what I want them to do. Visuals such as “all done,” “sit,” “clean up,” and “calm down” are on my list. I also use visual scheduling in treatment. For example, I might draw a chair with the child sitting down, then playdoh, cards for artic, and then clean up or a good-bye visual. As we complete each task, the child marks an X on it.

Empower students. We all want to be in control of our lives even when we can’t control our circumstances. This is the same for children. And although they cannot dictate the session, we can still give them choices, such as “You can sit in your chair or you can stand behind your chair,” or, “You can work for Legos or stickers,” or “You can finish your worksheet and earn your speech bucks, or sit in your chair and lose your speech bucks for the day.”

Encourage sensory integration. Some of your kids may struggle with focusing, staying still and controlling impulsiveness because their sensory regulation is off. Having fidget tools such as squishy balls available upon request may help your student. I explain that the squishy ball is a “tool” and if used as a toy, it will be taken away. Also, incorporating movement breaks or activities that infuse movement help keep our little speechies focused and in control of their body.

Abandon ship when necessary. We all plan wonderful, amazing treatment sessions filled with activities that we “think” all kids will love. Sometimes your most ideal therapy activities may not work for certain children. Don’t hesitate to abandon a toy or activity when a child does not appear interested in your fabulous board game! You will get more meaningful interactions with toys and activities that your students prefer, rather than trying to force them to like what you want to do. I always try to reintroduce an activity a couple weeks later to see if they may want to try it out again.

All in all, behavior management is an ongoing process that takes time, trial and error, and a willing SLP to dive in and try new techniques!

One of the more challenging clinical decisions that confront speech-language pathologists is what to do with a young child who stutters. Do we recommend intervention? Do we wait and see if the child recovers without formal therapy? A recent study published in Pediatrics by Reilly and colleagues has generated a significant amount of press, with headlines declaring that preschool children who stutter will “do just fine.”

Even though this message does not appear to be the intent of the authors (as per their more detailed podcast on StutterTalk), it is the message the media chose to run with in their headlines. There are several key points about the Reilly article, preschool stuttering, and our current research base that need to be evaluated before we make claims such as those put forward by the media.

First, the Reilly et al. study used temperament and behavior scales, which were not designed to assess reactions to stuttering or communication. In fact, of the three scales used, only one had a question relating to communication, and it was not about stuttering. So, while it certainly may be true that young children who stutter may exhibit normal temperament and behavior (a finding we should not be surprised by), this study did not actually assess reactions to stuttering or communication, as the misleading media headlines have suggested.

This brings us to the second point of discussion, which is the difference between early stuttering and normal disfluencies. For a child with normal disfluencies, a “wait and see” approach is much more acceptable than for a child with early stuttering. We often use the term “emergent” to describe skills that are developing, but have not fully emerged. Children with normal disfluencies have emergent fluency. Their skills are developing in this area. Children who exhibit signs of early stuttering are much more at risk for continued stuttering, without proper intervention. As such, the question for parents, physicians, SLPs and others, is “How do we know the difference?”

This can be a starting point to help determine risk. In addition, the child’s gender (boys are at a higher risk), time since onset (greater than 6 to 12 months is higher risk), age of onset (children who start stuttering at age 3 ½ or later are at higher risk), overall speech and language skills (it is important to assess all areas of speech and language), and level of parent concern also need to be considered.

Third, much of the problem that persists in our understanding the risk of early stuttering lies in the difference between population studies and clinical studies. Studies that have looked at recovery rate have been population studies, and thus likely captured many children who were experiencing “emergent fluency” rather than “stuttering.” The research does not translate well into clinical settings. While up to 80 percent of children in population studies may outgrow their “stuttering,” that number is far lower in a clinical setting.

Of the children seen in a clinical setting, many have several of the above risk factors that would put them at higher risk for continued stuttering without proper intervention. Children in a clinical setting are not a random sample of the population, but a specific subgroup with an identified concern (usually on the part of the parents) about stuttering. As such, speech-language pathologists need to be careful about discussing recovery rates with parents that may not apply to their child.

Finally, a “gold-standard” that allows us to predict with 100 percent accuracy which children need intervention does not currently exist. As such, we have to rely on current best practice: the integration of research evidence, clinical experience, and client values. Even if we assume that waiting to intervene will result in a similar outcome later, the reality is we do not know if waiting has a negative impact on social skills, self-confidence, and peer relationships.

Given the above information, what do we recommend to parents, physicians and SLPs? Parents are often the most reliable judge of their children. When they come to us with concern, it is warranted in most cases. Parents should trust their instincts. If they are concerned about their child’s stuttering, they should discuss those concerns with the child’s pediatrician and advocate for a consultation with a speech-language pathologist. Parents do not need a referral for an SLP. They can contact an SLP on their own (go to ASHA’s ProSearch directory of clinicians to find one in their area) or go through their public school or Child Find.

Pediatricians should refer to an SLP when any of the following are present in a child who is stuttering:

Child is experiencing negative reactions from other family members or peers

Through a collaborative effort between the parents, physicians, SLPs and others in the child’s community, we can make a significant difference for children who stutter.

Craig Coleman, CCC-SLP, BRS-FD, is assistant professor at Marshall University and president of the Pennsylvania Speech-Language-Hearing Association. He is an affiliate of ASHA Special Interest Groups 4, Fluency and Fluency Disorders, and 18, Telepractice.

Most parents tell me that their elementary school child has 20 to 25 minutes to enter the school cafeteria, search for her lunchbox buried in a portable tub, find a place to sit, open all the containers, eat (oh, right, eat), then clean and pack up before the bell rings. In an effort to ensure that their kids eat anything at all, well-meaning parents pack lunchboxes filled to the brim with typically, 7 to 8 different options!

Picture this: Your little first grader searches for spot in a sea of tables, newly found lunchbox in hand. She squeezes in between her best friends, climbing up onto the metal bench, feet dangling, with her little elbows resting on the much too high table top, just below her chin. Most school cafeterias provide the same size seating for the entire school, whether the kids are 3 feet tall or towering 5th graders, about to move on to middle school. Ever try to eat a meal on a narrow bench, your feet dangling and no back-rest? It’s not easy. By the time your child gets the plastic bags opened, the juice box straw unwrapped and poked hard enough into the box that it squirts her in the face, all while holding up her other hand to signal the teacher “Can you please open this lid?” well, another 5 minutes have passed by. Meanwhile, she’s excited to get out to recess, now just 15 minutes away.

As a feeding therapist, I visit lots of school cafeterias and have learned that parents and teachers have one priority: Getting kids to eat a nutritious lunch. In contrast, kids have this priority: Talking to their friends. How then, does a parent pack a lunch, especially for a picky eater or perhaps a child with special needs, that still allows their child some much needed “down time” to chat with friends yet fill their bellies quickly and nutritiously? Here are 3 strategies to do just that:

Send one easy open container plus a drink. I recommend EasyLunchboxes® BPA-free system, because the lid is easy for little fingers to pop off and instantly reveal 3 to 4 yummy choices. Another favorite is the Yumbox®, where the single tray is divided into ½ cup portions designed for the key food groups: Fruit, Veggies, Grains, Protein and Dairy. Both options are quick to open and not as overwhelming as a lunchbox filled to the brim with individual plastic bags, containers and/or drippy fruit cups with tricky foil lids

Pack “GRAB and GAB” food. Cut fresh fruit, veggies, sandwiches, cheese, etc. into small enough pieces that kids can grab a piece without gazing down and continue to gab with their friend across the table. My favorite speedy gadget is FunBites® which instantly creates grab and gab bites, yet has no sharp edges. It’s a fun way to get kids in the kitchen making their own lunch the night before – once again, get them involved and they are more likely to eat it later. For some kids, cutting a sandwich into a larger, fun shape like a dinosaur, keeps the conversation and the eating on the same track. But, for those kids who tend to just eat a sandwich and skip the other items, try cutting the sandwich into small pieces with a FunBite® so the child alternates “grabbing” a variety of foods, much like a mini-smorgasbord. Remember, you don’t need to send a whole sandwich when sending half leaves room in little bellies for other key food groups.

Include a power- packed smoothie that you made the night before. Freeze it directly in the cup (with a lid, of course) and be sure to include a wide straw. By the time your child opens her lunch, the smoothie will be the perfect consistency, plus it helped to keep the lunch cold. For elementary school age kids, refillable pouches are another option for healthy smoothie or puree blends. One of my favorites is the adorable 4.5 oz. Squooshi™, which is freezer and dishwasher safe and free of all the “bad-for-yous” like BPA, lead and phthalate. Recipes for kids of all ages can be found on the Squooshi website. Another terrific option is to fill a Sili Squeeze with Eeeze™ food pouch and freeze it with the cap on. Please note that the manufacturer does not recommend storing the Sili Squeeze™ in the freezer for an extended periods of time, but states on their website that “Sili Squeeze™ is the perfect lunch box addition to keep your child’s lunch cool and will be perfectly defrosted for lunch time!”

One elementary school that I visited was graciously flexible to help one little girl eat better. They provided a smaller table that fit her so that her feet could be on the floor (or try a box underneath little feet as a footrest). The table should be at sternum-height so your child can see her food and rest her arms for stability. Smaller tables also reduce cafeteria noise and foster social skills thanks to smaller groups of kids sitting together.

Here’s a picture of that sweet little girl. Note the easy “grab and gab” food in one (and only one) container. See the rest of the food on the table? That belongs to the two other kids seated across from her.

Tell me about your kids’ cafeterias – the good, the bad and the delicious! What can we do to help kids in school get more time and more options for a healthy lunch?

One could easily see the lack of males in our profession by walking into any elementary school, or even attending an ASHA conference. It’s no secret that males are a rarity in speech-language pathology, but the topic of conversation has now shifted to what we can do about this trend. The fact that I was a minority in our field was apparent to me immediately after attending my first articulation disorders course.

At this time, we have to use the information gathered by ASHA about why males are not choosing speech-language pathology, and develop concrete solutions on how to address the dearth of males in this profession.

The Frederick Schnieiders Research study conducted in 1997 revealed three common reasons males were less likely to pursue speech-language pathology compared with women: concerns about adequate income, concerns about advancement, and fears of limited opportunities for growth. Perry Flynn, an ASHA board member who blogged on this topic for ASHAsphere last week, shared an additional reason in the ASHA Leader article—lack of awareness:

“Men seem to have awareness and knowledge of many other related services—physical therapy, psychology, even occupational therapy, and certainly nursing—but no inkling of what a speech-language pathologist might do,” says Flynn, also associate professor at the University of North Carolina, Greensboro. Flynn’s insight holds true for me, as I knew very little about the scope of our profession before entering my junior year of undergraduate courses. However, as illustrated in the Leader article, there are issues beyond “awareness.”

Another explanation given of why men aren’t in the profession was that men are still unfairly viewed as less nurturing than women. I agree with Michael Maykish, an SLP in an elementary school in North Carolina, when he says, “You can’t generalize the notion that men aren’t nurturing.” Maykish goes on to say, “Successful SLPs are inherently nurturing, male or female. If you aren’t, you’re not going to enjoy being an SLP and probably shouldn’t be in this career.” We, as males, have an opportunity to promote our gender by directly showing we, too, can be nurturing.

Bringing awareness of CSD opportunities to the male population before they enter college will hopefully have a multi-pronged effect. This should give some insight and knowledge about the profession to some males who previously wouldn’t have considered going into our field, and possibly spark some interest. The male students who are now interested in CSD will act as a conduit, since, as history has shown, males influence other males regarding college major.

It is important that men in our field act as ambassadors, and take time to share the benefits of being in this profession with high school juniors and seniors. Word of mouth, coming directly from the source is a powerful tool.

Earning an adequate salary is obviously a concern for everyone, but, traditionally, it’s an even bigger one for males. Given the large numbers of SLPs employed in schools, developing ways to address this financial concern from a school-based perspective may be the best way to see the biggest return of male therapists. If we want to see the median income rise, I believe it is imperative we continue our efforts to separate ourselves, males and females, from teacher-related fields through continuing education and specialization. It is dispiriting to hear that SLPs are being offered entry level pay. We are highly qualified professionals who are in high demand. Consequently, negotiating a salary above entry level should always be an option, including when working with a school district.

Adding courses to your resume or becoming specialized in a particular area will only help school-based SLPs become more marketable and should result in higher incomes, which hopefully will attract more males to the profession. Providing treatment after school hours or during the summer are other ways to supplement a school salary, making the profession more appealing to salary-driven males.

I hope some of my suggestions are valid enough to spur even a small increase in the amount of males choosing CSD, as it is a remarkable field. A large section of my response focused on the financial aspect of our profession. I must admit the financial issue was not really relevant to me when I was considering the field. I guess I always felt if you work in a “helping” profession, you make some financial sacrifices. That said, I always felt my salary was fair, and if it wasn’t, it was my responsibility to change something.

Also, I realize much of this blog has been a testosterone-fueled rant, but I would be disappointed in myself if I didn’t thank all the wonderful female SLPs. When the demand of speech-language pathologists is still so high that I’m trying to convince more people to commit, regardless of gender, well, then the gender that has composed approximately 96 percent of our field for so long must be doing something right.

Kevin Maier II, MS, CCC-SLP, is an SLP in the Wyomissing Area School District in Pennsylvania.